Original Article|Articles in Press

Patient-Reported Outcomes and Survivorship Are Not Different for Primary Hip Arthroscopy Patients of Age 50 Years and Older Compared With a 20- to 35-Year-Old Matched Cohort at Minimum Five-Year Follow-Up

Published:February 19, 2023DOI:


      To assess clinical outcomes among patients aged 50 years or older after primary hip arthroscopy for femoroacetabular impingement (FAI) with or without labral tears compared with a matched control group of younger patients aged 20 to 35 years old at minimum 5-year follow-up.


      We conducted a retrospective comparative prognostic study using a prospectively collected database of patients who underwent hip arthroscopy with minimum 5-year follow-up. Subjects completed the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) before surgery and at 5-year follow-up. Patients aged ≥50 years were propensity score matched on sex, body mass index, and preoperative mHHS to controls aged 20 to 35 years. Pre- to postoperative changes in mHHS and NAHS were compared between groups using the Mann–Whitney U test. Hip survivorship rates and minimum clinically important difference achievement rates were compared between groups using the Fisher exact test. P values <.05 were considered statistically significant.


      In total, 35 older patients (mean age 58.3 years) were matched to 35 younger controls (mean age 29.2 years). Both groups were mostly female (65.7%) and had equal mean body mass index (26.0). Acetabular chondral lesions of Outerbridge grades III-IV were more prevalent in the older group (older 28.6% vs younger 0%, P < .001). Five-year reoperation rates were not significantly different between the groups (older 8.6% vs younger 2.9%, P = .61). There were no significant intergroup differences in 5-year improvement in mHHS (older 32.7 vs younger 30.6, P = .46) or NAHS (older 34.4 vs younger 37.9, P = .70) or in 5-year minimum clinically important difference achievement rates for the mHHS (older 93.6% vs younger 93.6%, P = 1.00) or NAHS (older 87.1% vs younger 96.8%, P = .35).


      There are no significant differences in reoperation rates and patient-reported outcomes between patients aged ≥50 years versus matched controls aged 20 to 35 years after primary hip arthroscopy for FAI.

      Level of Evidence

      III, retrospective comparative prognostic study.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Minkara A.A.
        • Westermann R.W.
        • Rosneck J.
        • Lynch T.S.
        Systematic review and meta-analysis of outcomes after hip arthroscopy in femoroacetabular impingement.
        Am J Sports Med. 2019; 47: 488-500
        • Casartelli N.C.
        • Valenzuela P.L.
        • Maffiuletti N.A.
        • Leunig M.
        Effectiveness of hip arthroscopy on treatment of femoroacetabular impingement syndrome: A meta-analysis of randomized controlled trials.
        Arthritis Care Res (Hoboken). 2021; 73: 1140-1145
        • Schairer W.W.
        • Nwachukwu B.U.
        • Suryavanshi J.R.
        • Yen Y.M.
        • Kelly B.T.
        • Fabricant P.D.
        A shift in hip arthroscopy use by patient age and surgeon volume: A New York state-based population analysis 2004 to 2016.
        Arthroscopy. 2019; 35: 2847-2854.e2841
        • Sing D.C.
        • Feeley B.T.
        • Tay B.
        • Vail T.P.
        • Zhang A.L.
        Age-related trends in hip arthroscopy: A large cross-sectional analysis.
        Arthroscopy. 2015; 31: 2307-2313.e2302
        • Lieberman J.R.
        Hip arthroscopy for femoroacetabular impingement patients older than 50 years-proceed with caution.
        Arthroscopy. 2019; 35: 2759-2760
        • Honda E.
        • Utsunomiya H.
        • Hatakeyama A.
        • et al.
        Patients aged in their 70s do not have a high risk of progressive osteoarthritis following arthroscopic femoroacetabular impingement correction and labral preservation surgery.
        Knee Surg Sports Traumatol Arthrosc. 2020; 28: 1648-1655
        • Allahabadi S.
        • Hinman A.D.
        • Horton B.H.
        • Avins A.L.
        • Coughlan M.J.
        • Ding D.Y.
        Risk factors for conversion of hip arthroscopy to total hip arthroplasty: A large closed-cohort study.
        Arthrosc Sports Med Rehabil. 2020; 2: e599-e605
        • Horner N.S.
        • Ekhtiari S.
        • Simunovic N.
        • Safran M.R.
        • Philippon M.J.
        • Ayeni O.R.
        Hip arthroscopy in patients age 40 or older: A systematic review.
        Arthroscopy. 2017; 33: 464-475.e463
        • Lin L.J.
        • Akpinar B.
        • Bloom D.A.
        • Youm T.
        Age and outcomes in hip arthroscopy for femoroacetabular impingement: A comparison across 3 age groups.
        Am J Sports Med. 2021; 49: 82-89
        • Joseph R.
        • Pan X.
        • Cenkus K.
        • Brown L.
        • Ellis T.
        • Di Stasi S.
        Sex differences in self-reported hip function up to 2 years after arthroscopic surgery for femoroacetabular impingement.
        Am J Sports Med. 2016; 44: 54-59
        • Kuroda Y.
        • Hashimoto S.
        • Saito M.
        • et al.
        Obesity is associated with less favorable outcomes following hip arthroscopic surgery: A systematic review and meta-analysis.
        Knee Surg Sports Traumatol Arthrosc. 2021; 29: 1483-1493
        • Krych A.J.
        • Thompson M.
        • Knutson Z.
        • Scoon J.
        • Coleman S.H.
        Arthroscopic labral repair versus selective labral debridement in female patients with femoroacetabular impingement: A prospective randomized study.
        Arthroscopy. 2013; 29: 46-53
        • Carreira D.S.
        • Shaw D.B.
        • Ueland T.E.
        • et al.
        Acetabular cartilage lesions predict inferior mid-term outcomes for arthroscopic labral repair and treatment of femoroacetabular impingement syndrome.
        Arthroscopy. 2022; 38: 3152-3158
        • Perets I.
        • Chaharbakhshi E.O.
        • Mu B.
        • et al.
        Hip arthroscopy in patients ages 50 years or older: Minimum 5-year outcomes, survivorship, and risk factors for conversion to total hip replacement.
        Arthroscopy. 2018; 34: 3001-3009
        • Domb B.G.
        • Chen S.L.
        • Go C.C.
        • et al.
        Predictors of clinical outcomes after hip arthroscopy: 5-year follow-up analysis of 1038 patients.
        Am J Sports Med. 2021; 49: 112-120
      1. Shanmugaraj A, Kumar MV, Al Naji O, Simunovic N, Philippon MJ, Ayeni OR. Hip Arthroscopy improves outcomes with moderate conversion to total hip arthroplasty rates in patients aged 50 years or older: A systematic review [published online August 31, 2022]. Arthroscopy.

        • Domb B.G.
        • Linder D.
        • Finley Z.
        • et al.
        Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.
        Arthroscopy. 2015; 31: 231-238
        • Norman G.R.
        • Sloan J.A.
        • Wyrwich K.W.
        Interpretation of changes in health-related quality of life: The remarkable universality of half a standard deviation.
        Med Care. 2003; 41: 582-592
        • Zhang Z.
        • Kim H.J.
        • Lonjon G.
        • Zhu Y.
        • written on behalf of AMEB- D.C.T.C.G.
        Balance diagnostics after propensity score matching.
        Ann Transl Med. 2019; 7: 16
        • Ramisetty N.
        • Kwon Y.
        • Mohtadi N.
        Patient-reported outcome measures for hip preservation surgery—a systematic review of the literature.
        J Hip Preserv Surg. 2015; 2: 15-27
        • Kucharik M.P.
        • Abraham P.F.
        • Nazal M.R.
        • et al.
        Arthroscopic acetabular labral repair versus labral debridement: Long-term survivorship and functional outcomes.
        Orthop J Sports Med. 2022; 1023259671221109012
        • Parvaresh K.
        • Rasio J.P.
        • Wichman D.
        • Chahla J.
        • Nho S.J.
        The influence of body mass index on outcomes after hip arthroscopy for femoroacetabular impingement syndrome: Five-year results in 140 patients.
        Am J Sports Med. 2021; 49: 90-96
        • Sogbein O.A.
        • Shah A.
        • Kay J.
        • Memon M.
        • Simunovic N.
        • Belzile E.L.
        • et al.
        Predictors of outcomes after hip arthroscopic surgery for femoroacetabular impingement: A systematic review.
        Orthop J Sports Med. 2019; 72325967119848982